Individual
VERA MELINDA SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1640 POWERS FERRY RD SE, MARIETTA, GA 30067-5491
(678) 427-1323
Mailing address
2522 SUGAR PIKE RD, CANTON, GA 30115-9417
(678) 481-1646
(770) 377-8432
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
070595
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN070595
GEORGIA LPN
GA
Enumeration date
02/29/2020
Last updated
02/29/2020
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